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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by former poster on September 22, 2010, at 0:36:59
Emsam 6mg patch doesn't interact with very many other meds. These are 2 AD's that have opposite side effects,(with the exception of low blood pressure). Emsam causes severe insomnia from its effect on mostly dopamine while Remeron causes extreme somnolence from its effect on serotonin. Remeron promotes dreaming while Emsam causes a dreamless sleep. Could Remeron provide the missing serotonin re-uptake that Emsam lacks at the reversible MAOI dose?
Posted by SLS on September 22, 2010, at 5:07:04
In reply to Emsam / Remeron combo?, posted by former poster on September 22, 2010, at 0:36:59
> Emsam 6mg patch doesn't interact with very many other meds. These are 2 AD's that have opposite side effects,(with the exception of low blood pressure). Emsam causes severe insomnia from its effect on mostly dopamine while Remeron causes extreme somnolence from its effect on serotonin. Remeron promotes dreaming while Emsam causes a dreamless sleep. Could Remeron provide the missing serotonin re-uptake that Emsam lacks at the reversible MAOI dose?
There are a couple of things that you wrote here regarding drug mechanisms that are not accurate. No big deal, though.
My doctor and I spoke about the theoretical possibility of safely combining Nardil with Remeron. My interest in Remeron is that it blocks certain serotonin receptors, primarily 5-HT2c. My doctor has not heard of it being done. Neither have I.
- Scott
Posted by former poster on September 22, 2010, at 19:45:21
In reply to Re: Emsam / Remeron combo? » former poster, posted by SLS on September 22, 2010, at 5:07:04
I wish I knew what to take to help me sleep with Emsam. It really seems like the right med for me until its bed time. Benadryl usually works for me to get to sleep, but not when I'm on Emsam. Ambien and Lunesta dont help at all. Only Clonazepam seems to help some and I dont want to increase the dose of that as I am trying to ween off of it. What is the benefit in blocking the serotonin 5HT2C?
Posted by Conundrum on September 22, 2010, at 23:33:28
In reply to Emsam / Remeron combo?, posted by former poster on September 22, 2010, at 0:36:59
Remeron doesn't block the reuptake of serotonin. The theory is that by blocking the alpha 2 adrenergic receptor that it increases serotonin, however studies have not born this out. At best it can redirect serotonin to some receptors, by blocking other receptors. I think the lack of any reuptake inhibition is one of the reasons it poops out so fast. The brain can just adjust to small changes at various receptors and upregulate or make some kind of adaption.
Posted by crabwalk on September 22, 2010, at 23:38:19
In reply to Emsam / Remeron combo?, posted by former poster on September 22, 2010, at 0:36:59
Remeron was the only thing that helped me after ~4 years of relentless insomnia (early awakening). Even low doses put me out. Makes it hard to get up in the morning though.
Posted by SLS on September 23, 2010, at 0:50:28
In reply to Re: Emsam / Remeron combo? » SLS, posted by former poster on September 22, 2010, at 19:45:21
> I wish I knew what to take to help me sleep with Emsam.
If you don't want to continue taking benzodiazepines, you can try taking low dosages of Seroquel (25mg - 75mg). With increasing dosages, Seroquel actually helps less with sleep.
> What is the benefit in blocking the serotonin 5HT2C?
It produces an increase in activity in the prefrontal cortex (PFC), an area known to facilitate higher thinking and influence mood. In depression, this area is often hypofunctional, and has been observed to show reduced tissue volume.
- Scott
This is the end of the thread.
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